Registration No.:
Permanent residence address:Street and No.:
City(municipality): / ZIP code:
District: / Country:
Postal address (if different from the permanent residence address):
Street and No.:
City(municipality): / ZIP code:
District: / Country:
Place of abode of the alien resident2):
Street and No.:
City(municipality): / ZIP code:
District: / Country:
University:
Faculty:
Detached department:
Study programme:
Field of study:
Form of study 4): / Method of study 5):
External educational establishment:
Topic of the dissertation thesis:
Adviser:
FILL IN LEGIBLY IN BLOCK CAPITAL LETTERS.
See p. 4 for notes.
Ministry of Education, Science, Research and Sport of the Slovak Republic,06/2016Page 1
Magister, Engineer, doctoral study passed at the following university:University:
Faculty:
Detached department:
Study programme:
Field of study:
Date of the commencement of study: / Date of completion of study: / Academic year:
In line with the University requirements, the applicant shall state their study achievements in individual grades of the completed Magister / Engineer / doctoral study at the university and shall attach photocopies of proof of their studies (the university degree diploma, the state examination certificate, and the diploma supplement).
The applicant shall specify in a separate annex their participation and achievements in conferences, competitions, students' research activity, authorship of discoveries or industrial designs, and the results of their spare time activity.
Ratings of Magister, Engineer, doctoral study in individual semesters(or produce atranscript of ratings of Magister, Engineer or doctoral study as prepared by the
relevant university Admissions Office)
Semester
Study subject / I / II / III / IV / V / VI / VII / VIII / IX / X / XI / XII
Weighted study average
(under ME SR Decree No.
614/2002Book of Statutes othe credit system of study)
Certification of the data correctness (unless the applicant is agraduate from the same university):
Date: Signature: Stamp impress of the Admissions Office
of the university/faculty:
Ministry of Education, Science, Research and Sport of the Slovak Republic,06/2016Page 1
Asurvey of further, even uncompleted, university study 6):University:
Faculty:
Detached department:
Study programme:
Field of study:
Level of education attained 7):
Date of the commencement of study: / Date of the completion of study:
Occupation(profession,employer´s name):
Previous: Present:
Declaration of and consent by the applicant
Ihereby declare that all the information I have provided is true, and that Ihave not withheld any material facts. In accordance with Section 11 Law Act No. 122/2013 Book of Statutes on the Protection of Personal Data and on amendments to certain laws I hereby give my consent by attaching below my handwritten signature to process my personal data for the purposes of the application to the date of enrolment in the first grade of my PhD. study at the university. This consent applies to the personal particulars given in the application form and its annexes, which the university is entitled to request under Section 58 paragraph 5 Law Act No. 131/2002 Book of Statutes on Higher Education and amending certain laws, as amended (hereinafter the "Law Act" ) in addition to the data according to Section 58 paragraph 3 Law Act. I understand that I may only revoke this consent in writing by giving the reasons at the appropriate university or faculty in the event serious reasons appear for doing so. I am also aware that the data may only be processed by authorized persons who are required to comply with provisions of Law ActNo.122/2013 Book of Statutes on the Protection of Personal Data and on amendments to certain laws, and the processed data shall be archived and disposed of in accordance with the legislation of the Slovak Republic.
Annexes to the application form:
1.Curriculum Vitae (CV),
2.Language certificates,
3.Proof of payment for the admission procedure,
4.Research proposal,
5.Relevant publications,
6.Certified copies of diplomas and certificate of citizenship,
7.Letter of motivation
8.
9.
10.
11.
12.
13.
14.
15.
Date: / Applicant´s signature:Ministry of Education, Science, Research and Sport of the Slovak Republic,06/2016Page 1
Instructions and notes for completing the application form:
This application form is intended for graduates of the Magister or Engineer or doctoral study,i.e. the second level study graduates who want to pursue their PhD. study, i.e. at the university study of the third level.
1)Tick the cross in the “Gender” entry.
2)In the “Civil ID No. of the alien citizen” entry, the ID number shall beentered, if assigned by the Ministry of the
Interior.The place of residence in the Slovak Republicshall also be entered.
3)The entriesspecifying the telephone No. and the e-mail address are optional particulars.
4)In the “Form of study”entry, enter the words “full-time study” or ”distance learning” or “combined” according to
theinformation on the study options.
5)In the “Method of study”entry, enter the words “full-time study” or ”distance learning” or “combined” according to
the information on the study options. The study programme, with which the method of study is not specified in the
instructions indicated by the university, the study is carried out in the full-time mode; distance learning or a
combined method of study is specified in the study programme.
6)In the event that the data are insufficient in thispre-printed form, please add a separate annex. Please also specify
your completed study, the study currently being taken or the uncompleted study (e.g. the number of semesters
attended).
7)Specify the “Level of education attained”entry by entering the following words: the second level of university
education, the joined firstand second levels of the degree study into a single unit, the third level of university
education.
8) The applicant shall attach other annexes as per the requirements of the university.
Applicants with special needs may apply for a form of the admission examination and the method of its implementation taking into consideration their specific needs.
Ministry of Education, Science, Research and Sport of the Slovak Republic,06/2016Page 1